British Journal of Neurosurgery
ISSN: 0268-8697 (Print) 1360-046X (Online) Journal homepage: http://www.tandfonline.com/loi/ibjn20
Transsphenoidal pituitary surgery C. Davis To cite this article: C. Davis (1992) Transsphenoidal pituitary surgery, British Journal of Neurosurgery, 6:5, 506-506, DOI: 10.3109/02688699208995046 To link to this article: http://dx.doi.org/10.3109/02688699208995046
Published online: 06 Jul 2009.
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Date: 16 March 2016, At: 18:59
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Letters to the Editors
Downloaded by [Ams/Girona*barri Lib] at 18:59 16 March 2016
only one was given a diagnosis for which there is an effective treatment other than for toxoplasmosis by the biopsy procedure. The yield of treatable conditions not covered by empiric toxoplasmosis therapy was thus 9%. This must be balanced against the mortality (9%) and the morbidity (18%) of the biopsy procedure. It would, therefore, appear on the basis of this report that, in this population, the risks of biopsy exceeded the potential benefit. PERRY A. BALL ERICHP. MARCHAND EDWARD C. BENZEL BRIAN K. WILLIS University of New Mexico, Division of Neurosurgery, FIG. 2. Lateral cerebral angiogram showing carotid artery aneurysm sitting on pituitary tumour. ~ Albuquerque, NM 8 7 1 3 ~USA
Reference 1 Pel1 MF, Thomas DGT, Whittle 1 R. Stereotactic biopsy of cerebral lesions in patients with AIDS. Br J Neurosurg 1991; 5 3 5 - 9 .
Transsphenoidal pituitary surgery SIR--Mr Adams> book review of Dr Hardy,s work on transsphenoidal pituitary surgery opens the debate on pre-operative angiography for this operation. 1 My understanding Over the
years has been that this examination is performed in order to assess any co-existing cerebral aneurysm particularly in acromegalic patients where there is a 10% incidence. The existence of an asymptomatic cerebral aneurysm may represent more of a threat to a patient’s life than the pituitary tumour itself, particularly if the surgeon should strike it during a transsphenoidal aPproach. Figures 1 and 2 show a patient with just such lesion at the back of the carotid artery; the aneurysm is not pointing laterally as usual but actually sitting on the tumour. Of course, cerebral angiography (until the arrival of MRI angiography) will carry a not inconsiderable risk and this also must be taken into account in the pre-operative work-up of such patients.
a
C. DAVIS Department of Neurological Surgery, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 4HT, UK Reference 1
FIG. 1. Axial C T scan showing large pituitary tumour and possible left carotid artery aneurysm lying behind it.
A d a m CBT. Review of: Hardy J, ‘Atlas of Transsphenoidal Microsurgery in Pituitary Tumours’. Br J Neurosurg 1992; 6:93.
ISSN: 0268-8697 (Print) 1360-046X (Online) Journal homepage: http://www.tandfonline.com/loi/ibjn20
Transsphenoidal pituitary surgery C. Davis To cite this article: C. Davis (1992) Transsphenoidal pituitary surgery, British Journal of Neurosurgery, 6:5, 506-506, DOI: 10.3109/02688699208995046 To link to this article: http://dx.doi.org/10.3109/02688699208995046
Published online: 06 Jul 2009.
Submit your article to this journal
Article views: 5
View related articles
Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ibjn20 Download by: [Ams/Girona*barri Lib]
Date: 16 March 2016, At: 18:59
506
Letters to the Editors
Downloaded by [Ams/Girona*barri Lib] at 18:59 16 March 2016
only one was given a diagnosis for which there is an effective treatment other than for toxoplasmosis by the biopsy procedure. The yield of treatable conditions not covered by empiric toxoplasmosis therapy was thus 9%. This must be balanced against the mortality (9%) and the morbidity (18%) of the biopsy procedure. It would, therefore, appear on the basis of this report that, in this population, the risks of biopsy exceeded the potential benefit. PERRY A. BALL ERICHP. MARCHAND EDWARD C. BENZEL BRIAN K. WILLIS University of New Mexico, Division of Neurosurgery, FIG. 2. Lateral cerebral angiogram showing carotid artery aneurysm sitting on pituitary tumour. ~ Albuquerque, NM 8 7 1 3 ~USA
Reference 1 Pel1 MF, Thomas DGT, Whittle 1 R. Stereotactic biopsy of cerebral lesions in patients with AIDS. Br J Neurosurg 1991; 5 3 5 - 9 .
Transsphenoidal pituitary surgery SIR--Mr Adams> book review of Dr Hardy,s work on transsphenoidal pituitary surgery opens the debate on pre-operative angiography for this operation. 1 My understanding Over the
years has been that this examination is performed in order to assess any co-existing cerebral aneurysm particularly in acromegalic patients where there is a 10% incidence. The existence of an asymptomatic cerebral aneurysm may represent more of a threat to a patient’s life than the pituitary tumour itself, particularly if the surgeon should strike it during a transsphenoidal aPproach. Figures 1 and 2 show a patient with just such lesion at the back of the carotid artery; the aneurysm is not pointing laterally as usual but actually sitting on the tumour. Of course, cerebral angiography (until the arrival of MRI angiography) will carry a not inconsiderable risk and this also must be taken into account in the pre-operative work-up of such patients.
a
C. DAVIS Department of Neurological Surgery, Royal Preston Hospital, Sharoe Green Lane, Preston PR2 4HT, UK Reference 1
FIG. 1. Axial C T scan showing large pituitary tumour and possible left carotid artery aneurysm lying behind it.
A d a m CBT. Review of: Hardy J, ‘Atlas of Transsphenoidal Microsurgery in Pituitary Tumours’. Br J Neurosurg 1992; 6:93.
